Around the year 1343 BCE a young boy came to the throne of Egypt. He was the last male heir in a long and powerful line of kings we today call the Tuthmosids, but he was only around eight years old. He followed on the heels of almost twenty years of social upheaval at the hands of Akhenaten, a king uniformly reviled by the pharaohs who succeeded him. Akhenaten had tried to install something akin to a henotheism or even monotheism in a culture that had been solidly polytheistic for millennia. Given that this young king, a boy called Tutankhaten, was too young to exercise real power or leadership, his powerful advisors and officials found themselves in a very convenient situation: they could use the little king to restore tradition and bring back the enormous cult of the proscribed deity Amun. And that’s exactly what they did.

One of the first things these officials did was change the boy-king’s name to Tutankhamun, “Living Image of Amun,” to help establish the fact that Amun was back. They married him to an older half-sister named Ankhesenpaaten, whose name was changed to Ankhesenamun, “She Lives for Amun.” They moved the nation’s capital from Akhenaten’s purpose-built city of Akhetaten back to Waset, the traditional religious capital of pharaonic Egypt. It is better known today as Thebes. (The modern place name is Luxor.) The god Akhenaten had venerated and whom he had forced upon Egypt as the new state deity, the Aten, was not proscribed but instead was returned to its former status as a minor aspect of the great sun deity Re. As for Akhenaten himself, the old king was branded a heretic and his name was not to be mentioned again; henceforth he was to be called “the criminal of Akhetaten.” The city of Akhetaten itself swiftly waned and fell into ruin, most of its stone temples and monuments disassembled down to their foundations by later kings and used as fill within the walls of massive temple pylons in the vast temple complex of Amun.

So came the reign of Tutankhamun, the boy-king. In our modern world he is synonymous with ancient Egypt. Most everyone has heard of him. To most people Tutankhamun is the most famous pharaoh of that long-ago civilization. He was certainly not the only one to come to the throne as a child in ancient Egypt, but the average modern person is not likely to be as aware of other boy-kings such as Pepi II.

The irony is, Tutankhamun was a minor king. He was something of a footnote in the history of ancient Egypt. He was likely forgotten within several generations of his own lifetime. This is largely due to two facts: he reigned for only around a decade and died at about eighteen years of age, and he was, after all, from the royal line of the reviled “criminal of Akhetaten” and was subsequently erased from their own history. Tutankhamun does not appear on any of the ancient kings lists of that great civilization. He was meant to be forgotten. We are not certain exactly how Tutankhamun was related to Akhenaten: many if not most historians used to believe he was the son of the heretic, but recent genetic testing has thrown that into significant doubt. That’s perhaps another story, but the point is, he was from the line of the heretic, so his fate was to be damned to eternal obscurity.

Until, that is, Tutankhamun’s tomb was found in 1922. Designated KV62 (Kings Valley Tomb 62), it was the first royal tomb to be found almost intact. Not completely intact, mind you, because it had been raided at least twice, but great quantities of burial goods were found in KV62: almost 5,400 objects packed into a rather ignominious little tomb the size of the average modern garage. No royal tomb unearthed to that point in time had been anywhere near as spectacular.

This is what has made Tutankhamun—King Tut—so famous in our own time. KV62 is one of the greatest archaeological discoveries in history and the event made its discoverer, a rather surly Brit named Howard Carter, a household name. He and Tut are forever linked in the annals of Egyptology.

But why did Tutankhamun reign for only ten years? What felled this king at such a young age? This is a question that has persisted in archaeology and the wider scientific community since the day the mummy was first unwrapped. And it is what we’re going to explore here.

I should caution before proceeding that to this day there is no universal agreement on any single explanation for the cause of death of this young king. It continues to be debated. I’ll share my own belief, but it is only one of many. They range from scientifically astute to absurd. Few ancient bodies have been as poked and prodded as the mummy of King Tut, but it does provide clues. So, first I think it best to go back to the beginning, to the first time the mummy was examined.

The Original Autopsy in 1925

Three years passed after Howard Carter discovered KV62 before his team got around to unwrapping and examining the mummy itself. The autopsy was led by an anatomist named Douglass Derry, who had considerable experience working with Egyptian mummies. The irony is, as meticulous as Carter was in painstakingly clearing the artifacts from the tomb, the autopsy was botched. Significant damage was done to the mummy of Tutankhamun. The mummy had been so thickly coated with resins and unguents when placed in its nested coffins 3,300 years ago that it was stuck fast when Derry, Carter, and the others tried to remove it. They ended up disassembling the mummy into numerous pieces. The head came off after a myriad of attempts to pry off the king’s iconic gold burial mask.

The mummy itself was in sorry shape even before Carter came along. As he notes in his publications, both the wrappings and body were heavily carbonized (Carter 2003 ed: 174, 198). This was evidently a chemical reaction due to the layers of resins and unguents that had been applied to the body in the mummification process, and was not associated with any antemortem condition or injury. It contributed to the fragmentation of the mummy during the rough handling in the autopsy.

Carter immediately observed that the mummy was that of a young man but there was no obvious sign of cause of death during the examination (ibid 198). Derry noted a fracture to the left distal femur, to the extent that the left patella (knee cap) was quite loose. It was placed in the mummy’s left hand when the autopsy was completed. The poor condition of the body presented many cracks and fractures, but given the limitations of the time it wasn’t clear if the fracture to the left leg happened before or at the time of death, or if it was the result of rough handling on the part of the embalmers 3,300 years ago.

Carter had hoped to X-ray the mummy of Tutankhamun, but the radiographer died on his way to Egypt.

The team built a tray, filled it with sand, and carefully reassembled the mummy within the sand. This was placed back into one of the coffins and finally into the quartzite sarcophagus, evidently with the hope that no one would notice the fragmented condition of the body.

The First X-rays: Evidence for Murder?

The first X-rays of King Tut were shot in 1968. This was conducted by a team from the University of Liverpool, and led by R.G. Harrison. Further X-rays were shot in 1978 by the University of Michigan, led by James E. Harris. In both cases the X-ray machine was brought to the tomb itself. That said, Harrison’s project was the first time the mummy had been viewed since Carter’s excavation over forty years earlier. Understandably Harrison was surprised to find the mummy in such poor condition; Carter’s little secret was out.

The series of X-rays revealed a number of things, including the oddity that the king’s sternum and frontal ribs were missing. This is a significant and often misunderstood point to which we will be returning. But it was the radiographs of the king’s skull that drew the most attention—at least later on. Neither Harrison nor Harris posited a clear cause of death but images of the skull showed an unusual difference in density to the base of the occipital bone (the bulge at the back of the skull) and a couple of loose bone fragments rattling around in there.

X-ray of King Tut’s skull. Note the loose bone fragment within. The arrow points to the base of the occipital bone.

In March 1999 a researcher named Bob Brier published a book entitled The Murder of Tutankhamen. Brier is not strictly an Egyptologist but is nonetheless a noted leader in the field of paleopathological studies of Egyptian mummies. He is also the first person to have mummified a human body since ancient times, for the sake of a scientific experiment. The experiment was highly successful and earned Brier the nickname of Mr. Mummy.

Brier had observed and studied the X-rays from 1968 and 1978, and wondered at the possibility of assassination. He is hardly the first to posit the idea of Tut’s having been murdered—the idea surfaced almost as quickly as the 1925 autopsy, given how young Tut was when he died. This coupled with the heretical line from which Tutankhamun came, has long made the idea plausible. Brier explored the idea in his book to a depth never before attempted (see Brier 1999). Was it Aye, the shrewd and old official who in fact succeeded Tut on the throne? Or was it Horemheb, the general of the army and thus a very powerful man?

Brier enlisted the aid of an expert investigator who suggested the difference in density to the base of the occipital bone might indicate a subdural hematoma, the result of a vicious blow to the head that resulted in coma and death. Then there are the loose bone fragments—more evidence of a blow to the head.

The idea of subdural hematoma struck me as somewhat plausible. What didn’t, however, was the bone fragments rattling around in the skull. When Tut was mummified late in Dynasty 18 the embalmers removed his brain through his nose, as was commonly done in elite mummifications. Then two courses of resin were poured into the cranial vault, another technique commonly used by ancient embalmers. This is evident in radiographs as opaque masses that solidified at the back as well as the top of the cranial vault.

X-ray showing the courses of hardened resin as a white, opaque mass at the back and top of the cranial vault.

What struck me as decidedly odd is, if the loose bone fragments resulted from a vicious blow to the head, why were the fragments not well embedded into the resin? So back then, while I personally considered assassination as a possibility, I myself was not completely certain of the scenario.

Raging Hippo, Panicked Horse?

A physician named R.W. Harer presented two odd explanations for Tut’s death. The first, in 2006, involved a hippo crushing Tut’s chest in its powerful jaws. The second, in 2011, posited that a horse kicked Tut, collapsing the chest cavity with fatal results (Rühli & Ikram 2013: 8). Both theories were presented at conferences of ARCE (American Research Center in Egypt). Neither theory is impossible. To this day the hippopotamus is one of the most dangerous animals in Africa, and its jaws could easily crush a man. And who knows how many people down through time have been killed by panicked horses?

Harer based his theories on the odd nature of the chest of Tut’s mummy. As I mentioned when describing the original X-ray imaging, the sternum and frontal ribs were missing when the body was examined in 1968. Carter never mentions this condition in his thorough notes, so that has been left unexplained. Harer wasn’t the first to focus on the damaged chest; another researcher explained it as possibly the result of a horrendous chariot accident. The chest was so crushed that the embalmers 3,300 years ago had no choice but to remove and discard the shattered sternum and ribs.

Here is a CT scan image showing the condition of the chest:

CT scan showing missing sternum and ribs, as well as other damage (adapted from Kmt magazine).

The frontal ribs were clearly cut away with a saw. Was this the result of “cleaning-up” work of ancient embalmers, or something else? Also notable is the absence of clavicles (collar bones). Moreover, there appears to be no evidence for the remains of Tut’s heart. The embalmers usually made every attempt to leave the heart in the thoracic cavity (for religious reasons), and though they weren’t always successful, every attempt would be made for a king, certainly.

In my opinion this mystery has been successfully solved, thanks primarily to a careful examination of archival photos conducted in 2007 (see Forbes, Ikram, and Kamrin, 51-56).

Howard Carter’s excavation photographer was Harry Burton, who was one of the finest archaeological photographers of his day. As Carter painstakingly cleared the king’s tomb in the 1920s, Burton photographed everything. This includes the mummy during the autopsy process. Below is a closeup of one of Burton’s photos of the unwrapped mummy prior to reinterment in KV62:

Original photo (1926) of the king’s mummy (adapted from Kmt magazine).

Compare this image with the previous one. In 1926 the chest was still intact. The clavicles were still in place. Note also the beaded cap on the mummified head, which is entirely absent in the previous CT scan image. Over the chest are several necklaces which Carter records in his notes as deliberately left in place because they were stuck firm within the resins coating the body. Perhaps the same was true for the beaded cap. Lastly, note the remains of eyelids. Compare this with a modern photo of Tut’s head:

Head of Tutankhamun as it is today.

In sum total, theories for ancient damage to the chest are probably best abandoned. Something must have happened between 1926, when the mummy was reinterred, and 1968, when it was next officially studied for the purpose of X-raying. In the interim was an event that involved nearly the entire planet: World War II. The theory is that during the war, when in fact the ancient tombs of Egypt were left largely unguarded, modern raiders entered the tomb to retrieve the embedded necklaces and beaded cap from the mummy. They cut through the chest to keep the necklaces intact, causing great damage, and roughly handled the head to remove the beaded cap (thus the frail eyelids disintegrated).

I agree with this theory. It best fists the available evidence thanks to Burton’s photos in 1926 and Harrison’s in 1968. On another note, Burton’s photos show that the king’s penis is intact, while the 1968 photos show it went missing, having broken off the body. It was later found within the bed of sand on which the mummy lies.

Disease?

A recent paper has thoroughly summarized the myriad of diseases different researchers through the years have suggested for Tut’s demise (Rühli & Ikram 2013). We needn’t delve into all of them, but a brief summary is in order. Through the years a number of researchers have posited all manner of ailments, including Marfan syndrome. This one was primarily due to the decidedly odd appearance of artwork in the Amarna Period, the period to which Akhenaten belongs:

Amarna Period stela of Akhenaten and Nefertiti

Akhenaten, his queen Nefertiti, and their daughters (as well as nobility in many cases) are shown with spindly limbs, long digits, drooping faces, overly full lips, wide hips, and pendulous breasts. Some of these characteristics do tend to fit Marfan. However, analysis of royal mummies from the Amarna Period have never shown indications of Marfan syndrome, so this is unlikely. It is more the consensus today that the odd human forms in the bodies of Amarna figures is a religious-artistic expression based on Akhenaten’s religious reforms, in a manner to express androgyny in the human form.

Some researchers have posited Klinefelter’s syndrome, Froehlich’s syndrome, or other disorders of the sort. The main problem here is that such disorders tend to cause infertility, and we know Akhenaten had six daughters (ibid 10). This cannot be the case for Akhenaten, but what if his line passed one of these disorders along to Tut? This also is implausible. Genetic studies of Amarna mummies conducted from 2007 to 2010 have fairly well confirmed that the two still-born infant girls found in KV62 in the 1920s are in fact Tut’s daughters (Hawass et al 2010: 641).

The same genetic tests revealed some interesting things about Tutankhamun, however. Macroscopic studies as well as genetic material have revealed traces of malaria tropica in the boy-king. This may not be what killed him, but it certainly would have weakened him and led to troubled health. On the other hand, in ancient times malaria often would have been fatal, if advanced enough. Also, CT scans during these examinations revealed two metatarsals in the king’s left foot with clear signs of deformation consistent with osteonecrosis (bone death) (ibid 642-643). This infection might also not have caused the king’s death, but there would have been no way in the Late Bronze Age to stop such infection and eventually it might have proved fatal had the king lived long enough. I’ll come back to that, but suffice it to say, by the time Tutankhamun died, he was already evidently weakened and ill.

The Original CT Scans: Questions Answered

Tutankhamun’s mummy was CT scanned for the first time in 2005. As with the X-rays and subsequent CT scanning, the device was brought to the tomb. The CT scanner kept overheating and there were jokes about the curse of King Tut, but several cheap fans aimed at the machine circumvented the curse.

Tut’s age at death has been variously estimated down through the years as anywhere between seventeen to twenty-seven years (Hawass 2005: 33). The CT scans in 2005 placed the estimate at eighteen or nineteen years of age at death, on which most researchers agree today.

The original CT scans is where the osteonecrosis of the left foot was first noticed. The king’s left foot was somewhat deformed and must have been painful. Telling is the fact that a great many walking sticks were found in the tomb when Carter cleared it in the 1920s. I was one, I must admit, who always pooh-poohed this as relevant to the king’s health because kings and noblemen were often buried with walking sticks. They were symbols of authority in pharaonic times. I should have known better. Tut’s tomb contained an overabundance of them. Subsequent analysis of these walking sticks show wear and tear to the tips of many of them, so clearly Tut needed them in life. His left foot was unstable.

The CT scans were very important in other ways. They were able to disprove a blow to the head as cause of death. Recall Bob Brier’s theory I mentioned earlier. The CT scans proved the difference in density at the base of the occipital bone was not related to any sort of injury. And the bone fragments rattling around in the cranial vault were identified as broken pieces of a cervical vertebra and part of the foramen magnum (ibid 34), the hole at the base of the skull through which the spinal cord passes. These fragments were more than likely broken loose in 1925 when Douglass Derry, Howard Carter, and the rest of the team were vigorously prying the gold burial mask off the mummy’s head.

As I mentioned earlier, during the original autopsy in 1925 Derry noticed a broken left leg. The fracture was at the epiphysis (growth plate) right above the left knee. The following images show the location of the fracture on the king’s leg:

Details of the king’s distal left femur. The arrow in the image at left points to the site of the fracture.

Now, the king’s body is covered with cracks and fractures, most hairline in nature. The mummy was found to be in poor shape in 1925. The carbonization that occurred naturally to the body down through time did a lot of damage. However, in this case, most of the scientists and researchers who examined the fracture were in agreement that the resins the embalmers had applied to the body during mummification, seeped into the wound itself. This means the wound must have been there prior to the mummification process.

This in turn indicates it must have been an injury sustained at or around the time of death.

What, Then, Killed King Tut?

I must stress again as I bring this to a close that there is no universal agreement on the cause of death of the famous boy-king. My article should make this much clear. However, I personally find much to agree with in the theory reached by Hawass and his team following the 2005 CT scans.

Tut was buried with six disassembled chariots in his tomb. He was clearly a typical teenager with a need for speed. Remember the left foot with the osteonecrosis, which is tied into this. A popular theory is that one day in the eighteenth year of Tutankhamun’s life, he was out riding one of his chariots when he hit a nasty bump. He was tossed upwards in the chariot, and came down on his unstable left foot, which couldn’t support his weight. He toppled out of the rapidly moving chariot and landed on his left leg, which shattered at the epiphyseal plate above the left knee. The damage was such that the kneecap was torn loose.

This would not have been survivable in the Late Bronze Age. While ancient Egyptian physicians were adept at treating many kinds of fractures, as is evident in human remains from that time, a compound fracture with such devastating injury would’ve been fatal. The fracture itself wasn’t the mechanism of death, but inevitable infection would have been. Tut more than likely died from gangrene.

Can we be sure it was a chariot accident? To this point in time no ancient Egyptian newspaper has been found reporting Tut’s lethal accident, but kidding aside, we can never be sure. It’s just a popular theory. Such an injury could just as easily been sustained in battle, perhaps from a Hittite battle axe, and there is evidence to suggest Tut himself led his army into battle at least once. But that, too, can only be a theory.

We will never know for certain how it happened, but I for one agree Tutankhamun died from infection after shattering his left leg 3,300 years ago.

I thank you for your time and attention. As always, I welcome comments and questions.